This study evaluated the prevalence and severity of ophthalmic manifestations in all Graves disease patients [n = 68] presenting to endocrine clinics at Mashad University of Medical Sciences between December 2002 and September 2005. The mean age of patients was 38.0 [SD 14.0] years, range 15 to 71 years. The most common complaints were foreign body sensation [54.0%] and puffy eyelids [48.4%]. The most common apparent abnormality was lid retraction in 64.2% of patients [bilateral in 95.3% of cases]. The patients had a mean modified Werner's NO SPECS classification score of 3.00 [SD 1.46]. The score was significantly higher in males than females [3.58 [SD 1.44] versus 2.63 [SD 1.35]] and was positively correlated with age